Treatments for medullary carcinoma

The following are treatment options for medullary carcinoma of the thyroid. Your healthcare team will suggest treatments based on your needs and the stage of the cancer. They will work with you to develop a treatment plan.

Surgery

Surgery is the first treatment for most medullary carcinomas. Surgery is often done after testing, and sometimes as treatment, for other tumours that develop when medullary carcinoma is associated with multiple endocrine neoplasia type 2 (MEN2), such as pheochromocytomaspheochromocytomasA tumour that starts in an adrenal gland (the glands on top of each kidney that release hormones to help control heart rate and blood pressure). and parathyroid glandparathyroid glandOne of 4 small glands attached to the thyroid in the neck that make and release the parathyroid hormone, which helps regulate calcium, magnesium and phosphorus levels in the blood. tumours.

Total thyroidectomy completely removes the thyroid. It is usually the first type of surgery done.

Neck dissection removes lymph nodes from the neck. The surgeon may also remove other tissues around the thyroid. The type of neck dissection done depends on the size of the tumour and if the doctor thinks there is cancer in the lymph nodes in the neck based on the results of an ultrasound. It is often done at the same time as the total thyroidectomy.

Surgery for metastasis could be used to treat medullary carcinoma that has spread to other organs and is causing symptoms. Find out more about metastatic cancer.

Palliative surgery may be done to debulkdebulkThe removal of as much of a tumour as possible. cancer that is causing pain or other symptoms. For example, the surgeon may remove part of a tumour that is pressing on the trachea.

Hormonal therapy

Hormonal therapy is a standard treatment after surgery for medullary carcinoma. It is used to replace the hormone thyroxine, which would normally be made by the thyroid.

The type of hormonal therapy used is levothyroxine (Synthroid, Eltroxin). It is given as a pill once a day. You will have to take levothyroxine for the rest of your life if you have a total thyroidectomy.

Radiation therapy

External beam radiation therapy may be offered for medullary carcinoma. It may be used to treat cancer in the neck that can’t be removed with surgery. It may also be used to treat cancer that comes back, or recurs, in the neck.

If medullary carcinoma spreads to the bone, external beam radiation therapy is sometimes used as a palliative treatment to relieve symptoms such as pain. Find out more about bone metastases.

Targeted therapy

You may be offered targeted therapy for locally advanced or metastatic medullary carcinoma. It may also be used to treat recurrent medullary carcinoma that can’t be removed with surgery (it is unresectable) and the cancer continues to grow and spread (it is progressing). Vandetanib (Caprelsa) is a targeted therapy drug used for medullary carcinoma. It is given as a pill.

Chemotherapy

You may be offered chemotherapy for locally advanced or metastatic medullary carcinoma if targeted therapy doesn’t work. It is usually given as a palliative treatment to help relieve symptoms. Chemotherapy drugs used for medullary carcinoma include doxorubicin (Adriamycin) and dacarbazine (DTIC).

Clinical trials

You may be asked if you want to join a clinical trial for medullary carcinoma. Find out more about clinical trials.